Tag Archives: healthy choices

Why turning off your phone is so hard, and what it means for losing weight

I had an interesting conversation with one of my students recently about making a behavior change. It brought up a good point. So good, I wrote about it in my Health & Fitness column in the Aiken Standard this week.


One of the courses I am teaching right now is Health & Behavior Change. In it we identify the major factors that contribute to chronic disease and discuss how to modify them to improve health. Throughout the course, the emphasis is on health behaviors and how to change them for the better.

For example, smoking is among the most difficult health-related behaviors to change. Obviously, there is the addictive nature of nicotine that makes smoking cessation challenging. Beyond the drug effect, smoking also has a behavioral component. This includes what a smoker does first thing in the morning, after a meal, or on a work break as well as the act of holding a cigarette in his or her hand. Add to that the social aspects of smoking, including the influence of friends and family members, and it is easy to understand why it is a difficult habit to break.

This same principle applies to other health behaviors, including eating and activity. Like smoking, what we eat and our activity level are complex behaviors that are difficult to change. Because of this, losing weight can be as difficult as quitting smoking for similar biological and behavioral reasons. We think of weight loss as being about a diet or exercise program, but it’s really about changing behaviors and habits.

his is a difficult concept to teach, so I have my students learn through experience. Since almost all of my students are non-smokers and most are active and at a healthy body weight, I have them complete a project in which they change some other behavior. They are responsible for identifying a behavior that has a negative effect on their life, coming up with a plan to change it, and embarking on a four-week behavior change experience.

One student wanted to change her social media habits. As a compulsive social media user, she spent more hours than she realized checking, posting, and commenting on Facebook, Twitter, and other sites. Her goal was to limit her social media time so that it didn’t interfere with classes or studying. One of the steps she took was to turn off the notifications that alerted her to new activity. This was helpful, but she still found the habit of checking her phone hard to break.

In a conversation, she noted that the one thing that would help more than anything else would be to switch her phone off during the day. This way she would have her phone if she needed it, but it wouldn’t be so easy, or tempting, to use it. Despite knowing the most effective strategy—the one thing—that would help her, she never did it.

I thought this was an excellent example of something that is common in making health behavior changes. In many cases, people probably know the one thing they need to do to be successful but for a host of reasons, they don’t do it. This may lead people to make other changes that aren’t nearly as helpful. While even the smallest behavior modifications can help, successfully losing weight or quitting smoking really does require making big changes.

This goes a long way in explaining why quitting smoking, losing weight, and changing eating and activity behaviors can be so difficult, even when people know what they need to do. There is no easy solution for this problem, but finding someone to hold you accountable for making the necessary changes and sticking to them is a good start.

Chill out! Why less stress is essential for good health.

Chronic stress can have serious emotional, psychological, and physiological effects that lead to or exacerbate many health problems. While it is impossible to avoid all stress in life, minimizing stressors and managing the way you respond to stress can have important benefits. Regular exercise, including yoga, managing time better, and getting enough sleep, can help with minimizing your feelings of stress as well as the effects it has on your body.

The importance of stress management and getting enough sleep is the topic of my Health & Fitness column in the Aiken Standard this week.


Chronic stress can have serious emotional, psychological, and physiological effects that lead to or exacerbate many health problems. In fact, the negative health effects of chronic stress are similar to those of eating a poor diet or not getting enough physical activity. That said, managing stress, including getting enough sleep, is often overlooked as a key component of good health.

The word “stress” is typically used to indicate both the feeling of being “under a lot of stress” as well as the things that cause that feeling. The events and situations that cause stress are properly called stressors, which lead to a stress response that includes consequences we feel as well as physiological changes we may not notice.

The immediate effect of a stressor is called the “fight or flight” response since it prepares the body to deal with a dangerous situation. A classic example of this is a caveman who encounters a saber-tooth tiger, clearly a stress-inducing event.

The sympathetic nervous system is immediately activated, which raises heart rate and blood pressure to pump more blood to the muscles. Additionally, stored fat and carbohydrate fuels are broken down as fuel for the muscles. The adrenal glands release catecholamines (adrenaline) and cortisol (the stress hormone) to prolong and enhance this effect. This coordinated response makes sure the caveman’s body is ready for action. After the danger passes, everything returns to normal.

This physiological response is appropriate for major events like saber-tooth tiger encounters, but not for less perilous stressors like being stuck in traffic, pressure at work and home, or other personal and family issues. But the body responds with the same increase blood pressure and hormones to them all. Unlike a rare saber-tooth encounter, these stressors tend to occur on a daily basis, leading to continuous stress response.

The increase in hormones can lead to high blood pressure, obesity, type 2 diabetes, and other chronic diseases. This is partly due to elevated levels of cortisol, a hormone that plays a role in storing fat and increasing appetite. While elevated cortisol during exercise (including running away from a saber-tooth tiger) is normal, chronic overproduction can have negative effects.

While it is impossible to avoid all stress in life, minimizing stressors and managing the way you respond to stress can have important benefits. To the extent that it is possible, avoiding stressful situations through better time management, setting realistic expectations for ourselves and with others, and learning to say “no” are common recommendations.

Learning how to deal with stressors to avoid the negative effects of stress is also important. Techniques that can be implemented in the heat of a stressful moment include taking a break from the situation, listening to calming music, and progressive relaxation. Even taking a deep breath can help.

Exercise has long been recognized as beneficial for reducing stress and the long-term effects of stress on your health. This includes doing something active during a stressful situation and exercising regularly to improve the way your body responds to stress. While all forms of exercise seem to work, much research and practice has focused on specific types of exercise including yoga and Tai Chi.

Other effective strategies traditionally include meditation and relaxation exercises. More and more research shows that getting enough sleep is also critical for reducing stress and the impact it has on your health. Eating a healthy diet can reduce the effects of stress as well.

The bottom line is that a healthy lifestyle includes stress management as well as a good diet and regular activity. Since all three are essential for good health, it would be wise to eat smart, move more, and chill out!

Celebrate Food Day every day by eating real food

This Friday is Food Day, an annual event that aims to raise awareness about the food we eat and the impact it has on our health, environment, and quality of life. It turns out that many of us don’t know much about our food including where it came from, the method of preparation, and the quality and nutritional value.

As I describe in my Health & Fitness column in the Aiken Standard this week, we are increasingly disconnected from our food, a fact that has implications for our health and the health of the environment.

Our lack of knowledge about the food we eat has been replaced by a heightened awareness about nutrients. In fact, many people follow diets that either emphasize or restrict certain nutrients in order to obtain health benefits. But the research to support the importance of these individual nutrients is often mixed or lacking altogether. Still, as we seek out sources of these nutrients we are led to supplements, such as fish oil, or processed foods with added nutrients, like fiber.

To be sure, fish oil and fiber are good for us. But does that mean that taking a fish oil supplement will have the same health benefits as actually eating fish instead of, say, fried chicken? Or is adding fiber to a chocolate breakfast bar equivalent to getting more fiber from fruits and vegetables? Both research and common sense suggest that the answer is no.

Beyond the individual nutrients, the food we eat has changed. Even the way food gets to our table has changed. Since nearly half of our meals are eaten outside the home, it’s not even “our” table anymore. And when we do eat at home, take-out and prepackaged heat-and-eat meals have become the norm. In fact, the idea of cooking meals from ingredients is so foreign that we have to be reminded about how and why we should do it.

Events like Food Day are an attempt to get us back to the basics of cooking and eating real food. This, of course, is how people ate for years before the obesity and diabetes epidemics we are dealing with now, so eating real food again is a step toward reducing these, and other, health problems.

In addition to the potential health benefits of focusing on food over nutrients, this approach is also good for the environment and the economy. It turns out that eating healthier food promotes sustainable agriculture and can support local farmers. Locally grown produce, which is picked at the peak of freshness, can be more nutritious and have a lower environmental impact than food from factory farms which is often shipped great distances. And most important, food from local farms usually tastes better!

This is the point of Food Day. We should make ourselves aware of where our food comes from and do our best to eat “real food” as opposed to processed and pre-packaged foods that tend to be high in calories, added sugar, salt, and unhealthy fats. When possible, we should buy foods that are grown locally to minimize the environmental impact and support local farmers who live, work, and pay taxes in our area.

It turns out that focusing on food, not nutrients, will have a positive impact on your health, the environment, and quality of life for you and others. And that is why it is called Food Day, not nutrient day. You can learn more about how you can celebrate Food Day every day at www.foodday.org.

“Heart” your heart.

Today is World Heart Day, with a focus on encouraging all of us to make heart-healthy choices to reduce cardiovascular disease risk. I thought that sharing some information about the heart, how it works, and how to keep it healthy would be an appropriate way to celebrate. This is also the topic of my Health & Fitness column in the Aiken Standard this week.

Your heart started beating months before you were born and will continue to beat every second or so…until it stops, signaling the end of your life. During your lifetime, your heart will probably beat more than two billion times, or about 100,000 times per day. (more interesting heart facts here)

The major function of the heart is to pump blood to all of your tissues through the arteries and back again through the veins. The heart has four chambers: the left and right atria that receive blood from the veins and the left and right ventricles that pump blood into the arteries. The right ventricle pumps blood to the lungs to pick up oxygen and the left ventricle pumps oxygenated blood out to the rest of the body.

The activity of your heart will vary throughout the day. At rest your heart rate is low, typically around 70 beats per minute. Some athletes have resting heart rates that are much lower, owing to their bigger, stronger hearts.

But when you are active your heart beats faster and more forcefully to eject more blood to the working muscles. During intense exercise, a young person’s heart rate can go above 200 beats per minute and the amount of blood pumped can be five times higher than at rest!

The heart is made up mostly of muscle that functions similarly to the skeletal muscles you use to move your body. But cardiac muscle is different in that it can spontaneously contract when stimulated by a specialized area of the heart called the SA node or pacemaker. And unlike skeletal muscle, the heart is remarkably fatigue-resistant, meaning that it can contract repeatedly without needing a break.

In order to beat continuously, the heart needs a steady supply of oxygen which is delivered through coronary arteries, not from the blood inside the chambers of the heart. Normally, plenty of oxygenated blood gets through. But if the coronary arteries become narrowed through atherosclerosis, the accumulation of plaque in the vessels, blood supply can be limited.

This can lead to reversible symptoms like angina pectoris (chest pain), especially during exertion. If a clot forms in the narrowed vessel, blood flow can be blocked completely causing a myocardial infarction (heart attack). Heart disease can be managed using medications, angioplasty, or bypass surgery, but the best approach is to prevent the problem from occurring in the first place.

Taking care of your heart is one of the most important things you can do for your health. Like other muscles, regular exercise can make your heart larger and stronger to pump blood more effectively. Exercise also lowers your blood pressure and can help reduce your blood cholesterol, further reducing the risk of heart disease.

A diet that is low in salt and unhealthy fats, like trans fats, can help lower blood pressure and cholesterol, slowing the process of atherosclerosis and preventing heart failure, a condition in which the heart muscle becomes weak. Maintaining a healthy body weight and controlling blood glucose are also keys to a healthy heart.

More than anything, though, your heart likes to be active. So celebrate World Heart Day by taking your heart for a walk!

 

Fat still matters

Last week I wrote about some recent research suggesting that low-carbohydrate diets may be better for weight loss that low-fat diets. For many, this study reinforced the notion that traditional recommendations are wrong and that the key to good health is to eliminate carbohydrates from your diet. This couldn’t be further from the truth.

The recent study did show that people lost more weight and experienced beneficial changes in blood lipids when they followed a low-carbohydrate diet compared to those who ate a low-fat diet. However, this does not mean that low-fat diets aren’t effective for weight loss or that they are “unhealthy.”

In fact, low-fat diets have long been used effectively to promote weight loss, reduce heart disease risk, and lead to healthier eating in general. This is supported by the results of hundreds of research studies as well as the practical experience of health professionals and real people. Here are two reasons why fat still matters when it comes to health.

First, reduced-fat diets have been shown to improve blood cholesterol and lower the risk for heart disease. Eating a diet low in fat, especially saturated and trans fat, has been the foundation of nutrition recommendations for decades. The fact is that these diets are effective for weight loss, reducing cholesterol, and otherwise improving heart health.

One famous study demonstrated that following a low-fat diet contributed to a reduction in the severity of atherosclerosis, the narrowing of arteries that leads to many heart attacks. Literally hundreds of other studies have shown similar beneficial results.

This isn’t some magical effect of eating less fat, though. The health benefits are likely due to eating more vegetables, fruits, and whole grains as much as they are to reducing fat intake. The point is that adopting a low-fat diet can lead to better nutrition overall.

Second, reducing fat intake is a good way to reduce calories. This is true because fat contains nine calories per gram, more than twice that of carbohydrates and protein, so cutting fat is an effective way to cut calories. Limiting fat intake also reduces calories indirectly because many high fat foods are also high in sugar and calories (think of most desserts).

It is important to mention that simply reducing fat intake won’t always lead to weight loss; total calories must be lower, too. This is a mistake many make when they reduce fat intake, but increase the amount of calories from other sources, typically carbohydrates. Many low-fat foods are actually relatively high in calories due to added sugar or people tend to eat more of them (the SnackWell Effect).

The effectiveness of low-fat diets for weight loss has been demonstrated in research studies (like this one) and countless weight loss programs. In one notable study, a diet low in fat even led to weight loss in people who weren’t trying to lose weight. And don’t forget that in the recent study about low-carbohydrate diets, the subjects that followed the low-fat diet also lost weight.

For some people, cutting carbohydrates as a way to lose weight is reasonable; for others, reducing fat intake makes sense. For most people, though, doing both to some extent is the best option, but going to extremes is unnecessary.

Eating less added sugar and avoiding foods with added fats (such as French fries) are good recommendations for almost everyone. That said, there is little evidence for the benefit of limiting carbohydrates in the form of whole grains, legumes, vegetables, and fruits or the fat in meat and dairy.

The bottom line is that the quality of food we eat is more important than the specific amounts of the nutrients it contains. Eating low-carbohydrate or low-fat diets can help steer you toward making healthier choices, but so can avoiding processed foods in favor of wholesome, nutrient-dense “real” food.

Good sources of protein for your low-carb diet

Thanks to a recent study and media coverage (including me), low-carbohydrate diets are a popular topic of discussion. For many people, cutting back on carbohydrates is a good way to reduce calories to promote weight loss.

Most low-carbohydrate diets also emphasize protein intake. But finding healthy protein sources is important for promoting weight loss and good health.

This recent discussion about the best protein for optimal weight loss  on the Train Your Body show on RadioMD should help.

The diet wars continue

If you are confused or frustrated by the conflicting claims about whether a low-fat or low-carbohydrate diet is the best, you are forgiven. First we were told that eating a low-fat diet was the best way to lose weight and improve heart health. Then, research suggested that low-carbohydrate diets were better. And back and forth it has gone for years.

During this time, the prevailing recommendations have suggested that a diet low in fat and high in carbohydrates was best. But more and more research has supported the notion that cutting carbohydrates, not fat, would lead to greater weight loss. Although this has been supported by some research, critics pointed out that eating more fat would raise blood cholesterol and other risks for heart disease.

According to a recent study, though, low-carbohydrate diets seem to have benefits for promoting weight loss and improving some indicators of heart health over low-fat diets. But you should hold off on shunning fruits and vegetables in favor of cheeseburgers! Here is a practical interpretation of the research and some common sense recommendations, taken from my Health & Fitness column in the Aiken Standard this week.

The study, published last week in the Annals of Internal Medicine, reported on 150 men and women who either restricted the amount of carbohydrates or fat they ate. After one year, the group that ate a low carbohydrate diet lost over 7 pounds more than the subjects on the low-fat diet. Additionally, the low-carbohydrate diet promoted greater improvements in blood lipids than the low-fat diet.

This is important for two reasons. First, this wasn’t a weight loss study; the researchers were simply following the subjects to see what would happen as they followed either diet. The fact that the low-carbohydrate group lost more weight suggests that it is relatively easier to cut calories following this type of diet.

This is consistent with other research showing that eating more carbohydrates, especially refined carbohydrates and sugar, can actually make people feel hungrier and eat more. Indeed, other studies have shown low-carbohydrate diets to be more effective for weight loss than low-fat diets (although a more recent study suggests there isn’t such a difference).

Second, the greater decrease in triglycerides and “bad” LDL cholesterol and increase in “good” HDL cholesterol in the low-carbohydrate group were different from what might be expected. Conventional wisdom holds that a low-fat diet should have a greater effect on blood lipids. Since weight loss can have a big effect on blood lipids, the improvement in the low-carbohydrate group may be due to losing more weight, not a direct effect of the diet.

It is important to note that the low-fat diet also led to weight loss in this and numerous other studies. The critical component of any weight loss diet is that it is relatively low in calories, regardless of what nutrients supply those calories. Really, almost any diet will lead to weight loss as long as it contains less energy than what is expended, but a low-carbohydrate diet may be more effective for weight loss than the traditional low-fat diet.

The bottom line is that the best diet is one that emphasizes eating wholesome foods, not on cutting carbohydrates or fat. That said, limiting carbohydrates in the form of refined grains and added sugar is an excellent way to reduce calorie intake and improve the overall nutritional value of what you eat. And shifting toward more monounsaturated fats (think olive oil and nuts) rather than worrying about the total amount of fat you eat is also a good idea.

Being mindful of eating habits, according to Shannon.

I had an interesting conversation with my friend Shannon earlier this week that fit with the topic of being mindful of health habits. (I have written about Shannon previously, but not for some time) 

She was telling me that one recent evening she drove to three fast food restaurants to get dinner for her family. Apparently, she wanted food from a different place than her husband, neither of which worked for her kids. As they sat down at the dinner table she became mindful of how ridiculous this was.

First, she spent almost an hour driving to fetch the food. This was time she could have spent doing any number of things, including actually preparing a meal for her family. Second was the cost, including the food itself and the gas required to drive to three different restaurants. Third, looking at the food they were eating made her realize that it wasn’t healthy. In fact, their meal included no fruits or vegetables (beyond french fries) at all!

What struck me was that the quality of the food they were eating was the last thing Shannon mentioned to me, almost as a afterthought. What got her attention was the time and money she sent on the food. Cooking at home could have taken less time and certainly would have cost less. It would have been healthier, too.

At least they ate dinner together

 

Being mindful of eating habits, according to Shannon.

I had an interesting conversation with my friend Shannon earlier this week that fit with the topic of being mindful of health habits. (I have written about Shannon previously, but not for some time) 

She was telling me that one recent evening she drove to three fast food restaurants to get dinner for her family. Apparently, she wanted food from a different place than her husband, neither of which worked for her kids. As they sat down at the dinner table she became mindful of how ridiculous this was.

First, she spent almost an hour driving to fetch the food. This was time she could have spent doing any number of things, including actually preparing a meal for her family. Second was the cost, including the food itself and the gas required to drive to three different restaurants. Third, looking at the food they were eating made her realize that it wasn’t healthy. In fact, their meal included no fruits or vegetables (beyond french fries) at all!

What struck me was that the quality of the food they were eating was the last thing Shannon mentioned to me, almost as a afterthought. What got her attention was the time and money she sent on the food. Cooking at home could have taken less time and certainly would have cost less. It would have been healthier, too.

At least they ate dinner together

 

Mindfulness matters for health.

According to a TIME magazine cover article from earlier this year, we are in the midst of a “mindful revolution.” Beyond being a trendy topic, mindfulness is important for making meaningful and lasting health behavior changes. This is the topic of my Health & Fitness column in the Aiken Standard this week. 


Mindfulness can be described as an awareness of thoughts, feelings, bodily sensations, and the surrounding environment. This is most commonly explored through mindful meditation, a practice that is credited with improving physical and mental health. Beyond meditation, being mindful can help to improve attention and focus in nearly every aspect of life.

 

Thinking about your actions and the effect they have on your health and the health of others can be good for you and those around you. It turns out that we engage in many health behaviors that are driven more by habit than conscious decision-making. This includes what, when, and how much we eat as well as how active we are, two of the most important determinants of health.

 

When was the last time you thought about what you were eating? Not just which restaurant to go to or what time to eat, but really thought about what and how much you ate? Chances are, at least some of the time you eat when you aren’t hungry or keep eating even when you are full. You probably also eat foods you know you shouldn’t or don’t intend to, sometimes without even realizing it.

 

This concept was explored in depth by Brian Wansink in the 2006 book, Mindless Eating. Based on his research, this book helped to explain the hidden reasons behind what, why, and how much we eat, often without being aware of it. This includes marketing tricks as well as environmental factors, many of which operate outside of our consciousness, that drive our food choices and prompt us to eat. 

 

This is where mindfulness comes in. By making an effort to be cognizant about your own thoughts and sensations as well as the environment you are in, you can prevent overeating and poor food choices.

 

Furthermore, we should be aware of how our food choices influence others around us. Research shows that children of parents who eat more fruits and vegetables tend to eat more of these foods than kids without such influence. Mindful eating includes accounting for how our actions and choices can influence the decisions of other family members and friends.

 

 

The same is true for how active or sedentary we are. Being active is a choice, sometimes a difficult one, that is influenced by other people and the environment. Most people spend the majority of the day sitting at work and at home, often without thinking about it. This sedentary lifestyle has been linked to an increased risk of obesity and heart disease, so it is relevant.

 

 

Sure, it feels good to sit on the couch to watch television. Think about it: is that really the best way to spend your time? At work, taking short breaks to get up from your desk and move can make you feel more alert and energized. Isn’t that worth it?

 

 

Similar to eating, our activity choices can influence the actions of those around us. A suggestion to walk to lunch can increase your own activity and that of your friends. Planning to go for a walk or bike ride with your family after dinner is a great way to share the benefits of activity.

 

 

When it comes to health, mindfulness matters. Being mindful about what you eat and make a choice to be more active allows you to have a positive effect on your health and the health of those around you.